Vertigo: What It Is | Treatments and Chiropractic Care

What is Vertigo?

The dizziness of vertigo can interfere with a person’s quality of life. Chiropractic care may be able to provide assistance to patients in managing their vertigo. It is a condition where a patient feels as if there is motion when there is not any real physical motion occurring. Vertigo is a type of dizziness due to a vestibular system dysfunction. It can cause balance problems, as well as nausea and vomiting. Objective vertigo occurs when the patient feels as if objects are moving. Subjective vertigo concerns the patient feeling as if they themselves are in a state of motion. A third type, pseudovertigo, is a very strong sensation of rotation from inside the patient’s own head. While this condition can affect anyone, the likelihood of a patient developing this condition increases with age and, it is a more common occurrence in women.

There are several causes of this type of dizziness. Benign paroxysmal positional vertigo, also known as BPPV, vestibular neuritis, labyrinthitis, vestibular migraine, concussion, and excessive alcohol consumption are some of the potential causes of this vestibular condition. The patient’s lifestyle and medical history could provide some insight on the likely cause. Performing a repetitive spinning motion can create a temporary type of dizziness, called physiologic vertigo, since it disrupts the vestibular fluids.

Central Vs Peripheral Vertigo

This kind of dizziness can be classified as central or peripheral. In central vertigo, the patient suffers an injury to the central nervous system (CNS), which probably takes the form of a lesion in the brainstem or cerebellum. This can lead to balance disorder and neurologic deficits, including issues like double vision and slurred speech.

Peripheral vertigo is caused by inner ear (vestibular) problems. BPPV is the most common form of this condition. Bacterial infections, flu, and inflammation can cause the transient type of this condition. Motion sickness is a common peripheral vertigo. Patients who are sensitive to motion sickness could have difficulty with flying in airplanes, riding in cars, or sailing on a boat. The feeling of motion could even persist for some time after the patient has disembarked and stands on solid, unmoving ground. Peripheral vertigo can be accompanied by symptoms like tinnitus, hearing loss, vomiting, pain, and imbalance.¹

Treatments

Typical medical treatments for this vestibular condition can include scopolamine, anticonvulsants, antihistamines, beta blockers, corticosteroids, benzodiazepines, antibiotics, or even a surgical shunt or ablation.² Medications have side effects, and they do not necessarily address the underlying cause of the problem.

For BPPV, canalith repositioning may be employed. BPPV is generally one of the easiest forms of vertigo to treat because of the canalith repositioning. This procedure has the patient go through a number of simple and slow maneuvers for positioning the head. It is the hope that these movements allow the particles of the semicircular canals of the inner ear to move to an area of the ear where they can be resorbed without trouble. The positions are each held for about a half of a minute. A chiropractor might assist in this treatment by watching the patient’s eyes and having the patient hold each position until visible abnormal eye movements and other symptoms cease. Patients need to sleep with the head elevated the night after the procedure to allow the particles to finish settling properly.

Rarely, in the cases where patients do not necessarily show a response to this method of treatment, surgery would be suggested. A “bone plug” would be used to block the part of the inner ear that is causing the dizziness. After surgery, the semicircular canal would be prevented from responding to head movements or particle movements.³

Chiropractic Care

Trauma of the head and neck, including whiplash, can trigger vertigo and dizziness. It can be treated by chiropractic care. BPPV, which is a common form of vertigo, presents with the patient feeling as if the “room is spinning”. Many of the medications prescribed for this type of condition can leave patients tired and unable to drive safely.

Chiropractors offer a natural alternative to medical treatments. They may use repositioning treatments and prescribe vestibular rehabilitation exercises.⁴ Brandt-Daroff exercises, for example, have the patient sitting on the edge of the bed and moving from one side, to upright, to the other side over one-minute intervals. Tai chi may also be a beneficial form of exercise as it can help the patient with developing a strong and controlled balance. Chiropractors can examine a patient’s lifestyle and make nutritional recommendations, including avoiding alcohol, tobacco, and caffeine. Meditation, breathing exercises, and relaxation techniques can help patients with managing this condition on their own. Finally, chiropractic manipulation can adjust the joints so that they move properly. This is especially helpful in the upper neck, to treat cervicogenic vertigo. The goal would be to get the patient to a point where they can manage their own symptoms.⁵